SILVER TSUNAMI: Is Broward Ready?

A newly-released comprehensive study examines Broward County’s readiness for a mass influx of elderly residents by 2030. Long waiting lists for elderly services, holes in the safety net, a lack of coordination between service providers, isolation and a poor perception of seniors were all key areas of concern raised by the study. Point! Publishing digs into the study’s findings.

By Danielle Charbonneau

The number of Americans ages 65 and older is set to explode from more than 46 million to over 98 million by 2060. Nearly 20 million Americans will be over the age of 85. Florida has the highest concentration of older residents in the U.S.; Adults over the age of 65 currently make up 22.5 percent of Broward County’s population, totaling roughly 430,000 residents. Broward County also has the fastest growing population of people over the age of 85 in the state. That population is projected to grow by 31.9 percent by 2030, totaling approximately 63,000 residents by 2030.

Given this mass influx of the elderly — an occurrence some are calling the “Silver Tsunami” — communities are faced with the question of how to prepare. The question prompted the Community Foundation of Broward, the United Way of Broward County and the Jewish Federation of Broward County to jointly commission a comprehensive study to pinpoint the specific needs and challenges facing the county’s elderly residents. The study — aptly titled “The Silver Tsunami: Is Broward Ready?”— utilized focus groups, key informant interviews, local, state and national data sources, surveys and public forums to gain a clearer understanding of elderly needs. A synopsis of the study was officially released in June and mailed to city government and community leaders in August. The full findings will be released sometime this Fall.

“This study was our first step. Now we are re-meeting and saying, ‘Now, based on this information, what is our next step? Is there a signature project? Is there a demonstration or activity to pursue?’ We’re in the process of doing that now,” said Linda B. Carter, the President and CEO of Broward Community Foundation, which manages philanthropic funds and provides grants to meaningful organizations.

The study boiled down to four key areas of concern: holes in the safety net, the effects of isolation on the elderly, limited finances of senior residents and the public’s poor perception of elders. Utilizing the study, Carter hopes city leaders, nonprofit organizations and philanthropic grant providers can band together to tackle the issues.

“We can’t solve this on our own. We need a whole community embracing this,” said Carter. “It’s the little things that everybody can do that equal a larger impact.”

Holes in the Safety Net

One of the key findings the Silver Tsunami study revealed was a lack of coordination “between medical, community-based, nonprofit and for-profit service providers, making it difficult to connect the dots to achieve a continuum of care.”

Mark Adler, the Executive Director of Meals on Wheels of South Florida, said this lack of coordination between service providers is a problem his organization sees frequently.

Approximately 650 volunteers for Meals on Wheels visit homes throughout Broward County each week to conduct intake assessments for elderly individuals in need of services. Meals on Wheels is Broward County’s only federally funded senior nutrition provider, delivering meals weekly to low-income, home-bound seniors who cannot leave their home without assistance and often have chronic health issues.

The Meals on Wheels volunteers are often the first point of contact for elders in need of assistance. The volunteers conduct an eight-page intake assessment and enter the individual’s information into a statewide database, which adds them to the waiting lists for state and federal programs. Then, the waiting game begins.

Waiting lists for senior services are long now, and growing longer. At Meals on Wheels, Adler said the wait list for free delivered meals is currently 1,013 people long. By comparison, Meals on Wheels serves free meals to 1,000 people; meaning the wait list exceeds the number of those being served.

Of the 1,013 people on the waiting list, 490 are considered “priority one” applicants. Priority one applicants are those who have no caretaker, little-to-no support, usually live alone, are home-bound, low income and often chronically ill. Adler shared a recent story of visiting a man on the wait list who had no legs, no family, was partially deaf, chronically ill and had no consistent way of getting food.

“He was living off peanut butter and jelly,” Adler said.

An individual like this can occasionally count on community food pantries or the kindness of acquaintances, but nothing consistent. Meals on Wheels does have a $50 a week food delivery service for five days of food, but for seniors applying for Meals on Wheels who often live solely on social security and receive, on average, only $600 to $800 a month in benefits, $50 a week is sometimes too expensive.

The Meals on Wheels waiting list, Adler said, also moves very slow. Last year only 82 spots opened up. Last month: only 12.

“Most of the people on our waiting list will die before they ever get meals from us,” Adler said.

In his time at Meals on Wheels, Adler said he’s witnessed the wait list go from being consistently around 300 people long about ten years ago, to now being consistently 1,000 people long. Adler attributes this to a variety of factors, but mainly decreased funding and increased need.

Meals on Wheels receives 65 percent of their budget from the Older Americans Act (OAA). The federal budget for nutrition services through OAA has decreased by roughly 43 percent, dropping from $10,002,339 in 2005 to $5,726,047 in 2018 [see table 1], while the cost of living and the overall need (due to a vastly growing older population) has increased.

Adler said eight years ago Meals on Wheels was almost entirely funded by the OAA, but as funding has decreased, the Meals on Wheels executive team has pushed to diversify funding.

Meals on Wheels is just one example of a senior service with a long waiting list. The waiting list for Medicaid managed long-term care through Broward County is over 3,000 long. The Silver Tsunami study revealed more than 6,500 Broward seniors are currently on waitlists for elder services. [see table 2]

TABLE 2: Administration on Aging (AoA) Nutrition Services Incentive Program Annual Cash Allocation to the State of Florida(under Title III of the Older Americans Act):

“That was something I found surprising,” said Kirk Englehardt, Vice President of Marketing and Communications for the Broward Community Foundation. “Think about it — one senior waiting months or years to get whatever service they might need is one too many…We need to dig in to that to figure out why.”

While seniors are on waiting lists for state and federal programs, Adler said coordinating with other nonprofit service providers and creating a continuum of care has been challenging. In the past, because of HIPAA laws, service providers could not share information. Adler is working toward a solution. About three months ago, he helped to create a Senior Services sub-committee of the nonprofit executive alliance of Broward (which is made up of 80 CEOs and executive directors of Broward County nonprofit organizations). The committee is working on building a “blanketed memorandum of understanding” for all the agencies that are members of the committee to allow them to exchange client information once a client has signed a release of information.

“That way we can actually talk to each other,” Adler said. “That’s just the tip of the iceberg. That’s kind of the first step in trying to coordinate some of the care.”

Adler said navigating the senior services arena is extremely challenging, even for him.

“Even as a nonprofit CEO in Broward I still find it hard to access the things I am trying to find for clients,” he said. “Really that coordination of everything is key. There’s such limited resources and our older adults have limited capacities in how much they can actually handle on their own, so every little barrier that’s put up becomes a giant roadblock if they can’t get past it.”

Effects of Isolation

The second key finding the Silver Tsunami study found was that isolation of seniors is of extreme concern. Isolation contributes to increased depression and anxiety, reduced community engagement, reduced nutrition and medication management, and increased medical problems.

“Isolation is especially bad for those who have lost a loved one or lost mobility,” the study stated. “This issue was further amplified when seniors didn’t have local family for help.”

“Elders often feel trapped with no purpose and nowhere to turn,” Carter said. “One of the ways to combat isolation is to create communities where seniors can ‘age in place’ — walk, shop, get care and maintain a good quality of life near their home.”

Carter said she hopes cities will think strategically when it comes to urban planning and development.

A representative for the City of Pompano Beach said the City has already started to take the Silver Tsunami into account as reflected in two recent decisions.

In 2016, the City of Pompano Beach’s Development Review Committee approved plans for Heritage at Pompano Station — a mixed-use, residential complex located at 400 N. Flagler Ave. that will target tenants over the age of 55 and will be located in the City’s planned walkable downtown area. Heritage at Pompano Station will have seven stories and 116 one- and two-bedroom apartments.

In addition, the City of Pompano Beach proposed using $8 million in GO Bond funds to construct a new senior citizens center to handle increased demand for senior programs in the NW sector of the city. The GO Bond was voted for and approved on April 24 of this year. The center will be constructed using the Bond once a property can be acquired.

Jerry Stryker, the CEO of John Knox Village — Pompano Beach’s largest elderly community, which houses approximately 900 people over the age of 62 on a 70-acre campus — said another way to combat isolation is to find ways to engage seniors with the community at-large. He hopes John Knox Village will eventually be connected to Pompano Beach’s planned downtown and Innovation District via walkable paths and public transportation.

Stryker has been a vocal advocate for ending isolation and bridging generational gaps. He envisions Broward County as a place where not only do the young and old intermingle to “work, live and play,” but where the young serve their elders and the old teach the young. He said multi-generational exchange is critically important.

Englehardt agreed: “There doesn’t seem to be the amount of value placed on seniors as we should. The wealth of knowledge… they have spent their lives contributing, not only to our country, but to our community right here. There is so much that they still have to offer but instead there’s this tendency to cast them aside and treat them as a burden instead of taking them and squeezing every drop of value out of them and making them continue to feel valued as a part of this community. ”

The poor perception of the elderly — a lack of respect and the tendency to cast aside — was another key issue raised in the Silver Tsunami study.

Limited Finances

As reported by the Social Security Administration in March 2018, the average social security benefit in the state of Florida was $1,395.31 a month. While the Social Security Administration recommends seniors only rely on social security for 40 percent of their living costs, many seniors are outliving their savings and living entirely on social security benefits.

With the high costs of living, expensive medical bills and relatively low social security benefits, the study found many seniors are struggling financially.

According to American Fact Finder’s 2016 statistics, 23.4 percent of Pompano Beach seniors and 17.7 percent of seniors in Deerfield Beach live below the poverty guideline. In Pompano Beach, that equates to almost one out of four seniors.

“The study revealed that the problem wasn’t that seniors had failed to save, but rather their longevity — combined with the cost of living — is exceeding their savings,” stated the study.

The study concluded that creating more affordable options for housing, medical services and caregiver support will be critical as the Silver Tsunami approaches.

While the long-term effects of the Silver Tsunami cannot be entirely predicted, the study urges all community members and leaders, at the local, state and federal level, to prepare.

“If we don’t act now, we will face a crisis that significantly impacts our community,” the study states. “Now is the time to step up and shape Broward’s future. The wave is coming and there’s no time to delay.”